Background: Carbapenem-resistant Gram-negative bacilli (CR-GNB) represent a critical threat to patients in intensive care units (ICUs), where limited therapeutic options contribute to elevated mortality. In Latin America and the Caribbean (LAC), the epidemiological burden of CR-GNB remains insufficiently characterized due to fragmented surveillance systems. This systematic review aimed to synthesize pooled prevalence estimates of CR-GNB among Gram-negative isolates recovered from ICUs across LAC countries. Methods: This systematic review was prospectively registered with PROSPERO (CRD420251177826), followed PRISMA 2020 guidelines and the JBI Manual for prevalence reviews. We searched PubMed, Scopus, LILACS, and SciELO from January 2015 to October 2025 without language restrictions. Observational studies reporting phenotypic carbapenem resistance data from ICUs in LAC countries were eligible. Two reviewers independently screened studies and extracted data. A two-level multilevel generalized linear mixed model (GLMM) with logit transformation was employed using a random-effects approach. Risk of bias was assessed using the JBI critical appraisal checklist. Results: Of 25 eligible studies spanning eight countries, 12 contributed 49 observations to quantitative synthesis. Overall pooled prevalence of CR-GNB was 28.88% (95% CI: 17.32-44.05%), with considerable heterogeneity (I2 = 95.24%). Species-specific prevalence was highest for Acinetobacter baumannii (72.58%), followed by Klebsiella pneumoniae (37.48%) and Pseudomonas aeruginosa (29.93%). Regional stratification revealed higher prevalence in South America (31.81%) compared to North America (22.65%) and the Caribbean (11.63%). Conclusions: Nearly one-third of Gram-negative isolates from LAC ICUs exhibit carbapenem resistance, with A. baumannii predominating. Substantial inter-study heterogeneity underscores the need for standardized regional surveillance networks and coordinated antimicrobial stewardship initiatives.
Objetivo: Evaluar la correlación entre los parámetros del Doppler transcraneal (DTC) y el score de Rotterdam (SR) e identificar los factores clínicos y radiológicos asociados con las alteraciones hemodinámicas cerebrales en pacientes pediátricos con lesión cerebral traumática (LCT). Métodos: Estudio observacional, prospectivo y correlacional realizado en 30 pacientes con LCT. Se recopilaron datos de edad, escala de coma de Glasgow y severidad del trauma (ST) a partir de la historia clínica. Las mediciones hemodinámicas se realizaron mediante DTC durante las primeras 48 horas del ingreso. Se registraron las velocidades de flujo de la arteria cerebral media y de la arteria carótida interna, así como el índice de resistencia, el índice de pulsatilidad y el índice de Lindegaard (IL), bilaterales. Se aplicaron análisis de correlación de Spearman y modelos de regresión lineal múltiple. Resultados: El IL derecho mostró la correlación positiva más fuerte con el SR (ρ = 0,52, p = 0,002). El IL derecho fue el parámetro que presentó la asociación estadística más significativa con la ST (p = 0,002). En los análisis multivariados ajustados por edad y sexo, el SR (β = 0,52, p = 0,045) y la ST (β = 0,84, p = 0,012) mostraron asociaciones significativas e independientes con el IL derecho. Conclusiones: El IL derecho se asoció de manera significativa con el SR y con la ST en pacientes pediátricos con LCT. Este hallazgo sugiere que dicho parámetro del DTC podría constituir un potencial marcador hemodinámico en la LCT infantil.
Globally, depression has seen a significant increase of 25
This study evaluated the experimental infectivity and pathological response of Skrjabinisakis physeteris (s.l.) larvae in Wistar rats following exposure to culinary spices commonly used in Peruvian ceviche (Citrus limon, Capsicum pubescens, Allium sativum, and Piper nigrum). Between November 2018 and April 2019, 787 specimens of Pacific bonito (Sarda chiliensis) were examined, revealing a 49.4% prevalence of anisakid larvae. Morphological analysis showed that 85.6% of recovered larvae corresponded to Anisakis Type II, which were selected for experimental infection prior to molecular confirmation. Larvae were exposed to spice treatments for 1 and 3 h to simulate traditional marination practices, and histopathological assessment was performed 48 h post-inoculation. Of the 489 larvae administered, 102 (20.9%) were associated with lesions in gastrointestinal and extraintestinal tissues. Compared with the saline control group, spice-treated larvae showed reduced recovery and pathogenicity, particularly after 3 h of exposure. Molecular characterization of a representative subset of Type II larvae based on mitochondrial cox2 sequences grouped them with reference sequences of S. physeteris available in GenBank. The observed sequence divergence was consistent with intraspecific variation within S. physeteris (s.l.). These findings indicate that the infective and pathological responses of S. physeteris (s.l.) vary following exposure to culinary spice treatments, while confirming its capacity to induce acute inflammatory and necrotic lesions in a mammalian host. This study provides molecular confirmation of S. physeteris (s.l.) in S. chiliensis from the central coast of Peru and underscores its potential zoonotic relevance in the context of raw fish consumption. These results contribute to improved risk assessment and seafood safety surveillance in the Southeast Pacific.
ObjectiveAutosomal recessive diseases represent an important group of genetic disorders whose frequency may be reduced through population screening strategies or premarital diagnosis, particularly in low- and middle-income countries, where some of these conditions have personalized treatment options that are often not covered by healthcare systems. The aim of this study was to determine the frequency of carriers of autosomal recessive monogenic disorders among patients who underwent exome sequencing at a national pediatric referral hospital in Peru.Materials and MethodsAn observational study was conducted in which carrier frequency was calculated based on pathogenic or likely pathogenic variants identified through exome sequencing. Additionally, assumptions from the Hardy-Weinberg equilibrium were applied to estimate the expected frequency of affected individuals in the population. Exploratory analyses were performed to estimate the odds ratio to evaluate the possible association between the geographic origin of patients or their grandparents and the presence of recessive variants.ResultsThe sample included 178 patients who underwent exome sequencing. In the analyzed cohort, approximately one pathogenic or likely pathogenic heterozygous variant per individual was identified, and at least 63.5% of participants were carriers of at least one genetic condition.ConclusionCarrier frequencies for genes such as GJB2, PAH, and ABCA4 were slightly lower than those previously reported. Similarly, the estimated prevalence of potentially affected individuals showed variations compared with previous studies across different disease groups. These differences may be explained by demographic and evolutionary factors that influence population genetic structure.
